The Senior Manager, Quality -Dual Eligible Program and MLTSS supports the Director in all quality, regulatory and accreditation related activities. This includes, but is not limited to efforts associated with the National Committee for Quality Assurance (NCQA), Healthcare Effectiveness Data and Information Set (HEDIS), the Department of Medical Assistance Services (DMAS), the Centers for Medicare and Medicaid Services (CMS) and other required entities associated with or required by the state and/or federal government. Additionally responsible for the quality oversight and management of the assigned line of business to include program development leadership and staffing. The core functions of this role focus on establishing quality performance initiatives impacting outcomes for the populations. This role assists in the identification and assessment of care gaps with resulting oversight and management related to quality strategies. This role works closely and collaboratively with various functional areas of the organization to achieve the goals and objectives of the Quality Program. Travel to regional offices is sometimes required.
MINIMUM EDUCATION REQUIREMENTS:
SPECIAL KNOWLEDGE AND/OR SKILLS:
WORK BACKGROUND EXPERIENCE:
Virginia Premier Health Plan, Inc. is a managed care organization which began as a full-service Medicaid MCO in 1995. Partnered with VCU Medical Systems we strive to meet the needs of the underserved and vulnerable populations in Virginia by delivering quality driven, culturally sensitive and financially viable Medicare and Medicaid healthcare programs. Headquartered in Richmond, VA we also have offices in Roanoke, Tidewater and Bristol with additional satellite locations allowing us to serve over 200,000 members across eighty counties throughout Virginia.
We offer competitive salaries and a comprehensive benefits package to include excellent Medical, Dental and Vision Plans, Tuition Assistance, Infant-At-Work Program, Remote Work options and generous vacation and sick leave policies. Our culture supports an environment where employees can continuously learn and gain professional growth through various development programs, education, exciting projects and career mobility.
All qualified applicants will receive consideration for employment without regard to age, race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status. EOE
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